Retinal pigment epithelial tears associated with trauma.

Two previously healthy patients, a 66-year-old man with blunt trauma to the right eye, and a 28-year-old man with head trauma from a motorcycle accident, were observed to have parafoveal retinal pigment epithelial tears after injury. In both patients, fluorescein angiography demonstrated mottled window defects in the areas of the tears, and blocked fluorescence in the areas of the rolled-up pigment epithelium. Neither eye had evidence of pigment epithelial detachments. We hypothesize that this unusual phenomenon is caused by an acute tractional force oriented tangentially to the macular plane, the result of a rapid spherically expansile deformation of the globe during trauma.